摘要
【目的】观察针刺联合推拿治疗瘀血阻络型椎动脉型颈椎病的临床疗效。【方法】将106例瘀血阻络型椎动脉型颈椎病患者随机分为观察组和对照组,每组各53例,对照组给予推拿治疗,观察组在对照组治疗的基础上,联合针刺治疗,连续治疗2周。治疗2周后,评价2组患者的临床疗效,观察2组患者治疗前后血清白细胞介素6(IL-6)、转化生长因子β1(TGF-β1)、神经元特异性烯醇酶(NSE)的变化情况,以及血清内皮素(ET)、肿瘤坏死因子α(TNF-α)的情况,比较2组患者治疗前后右侧椎动脉(RVA)、左侧椎动脉(LVA)及基底动脉(BA)的变化情况。并评价2组患者治疗前后中医总症状积分以及颈椎活动功能指标的变化情况。【结果】(1)治疗后,2组患者的血清NSE、ET水平均明显改善(P<0.05),且观察组在改善血清NSE、ET水平方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的血清TNF-α、IL-6、TGF-β1水平明显改善(P<0.05),且观察组在改善血清TNF-α、IL-6、TGF-β1水平方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者椎体屈伸活动范围、椎体角度位移明显改善(P<0.05),且观察组在改善椎体屈伸活动范围、椎体角度位移方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者中医总症状积分明显改善(P<0.05),且观察组在改善中医总症状积分方面明显优于对照组,差异有统计学意义(P<0.05)。(6)治疗后,2组患者RVA、LVA、BA明显改善(P<0.05),且观察组在改善RVA、LVA、BA方面明显优于对照组,差异有统计学意义(P<0.05)。(7)观察组总有效率为96.23%(51/53),对照组为75.47%(40/53)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】针刺联合推拿治疗瘀血阻络型椎动脉型颈椎病,能明显抑制炎性介质,调节血管内皮功能,改善患者的椎动脉血供以及颈椎功能,临床疗效显著。
Objective To observe the clinical efficacy of acupuncture combined with massage in the treatment of vertebral artery cervical spondylosis(VACS)of blood stasis blocking collaterals syndrome. Methods A total of106 cases of VACS patients of blood stasis blocking collaterals syndrome were randomly divided into observation group and control group, 53 cases in each group. Both groups were treated with massage therapy, and the observation group was given additional acupuncture therapy, the treatment lasting 2 consecutive weeks. After2 weeks of treatment,the clinical efficacy of the two groups was evaluated. The changes of serum interleukin 6(IL-6),transforming growth factor β1(TGF-β1),neuron-specific enolase(NSE),serum endothelin(ET)and tumor necrosis factor α(TNF-α)were observed in the two groups before and after treatment. The changes of right vertebral artery(RVA),left vertebral artery(LVA)and basilar artery(BA)were compared between the two groups before and after treatment. The total symptom score of traditional Chinese medicine(TCM)and the changes of cervical motor function indexes were evaluated in the two groups before and after treatment. Results(1)After treatment,the levels of serum NSE and ET in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving serum NSE and ET levels, the difference being statistically significant(P<0.05).(2)After treatment,the serum levels of TNF-α,IL-6 and TGF-β1 in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the serum levels of TNF-α,IL-6 and TGF-β1,the difference being statistically significant(P<0.05).(3)After treatment,the range of vertebral flexion and extension motion and the angular displacement of vertebral body in the two groups were significantly improved(P<0.05), and the observation group being significantly superior to the control group in improving the range of vertebral flexion and extension motion and the angular displacement of vertebral body,the difference being statistically significant(P<0.05).(4)After treatment,the total symptom score of TCM in the two groups was significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the total symptom score of TCM,the difference being statistically significant(P<0.05).(6)After treatment,RVA,LVA,BA in the two groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving RVA, LVA, BA, the difference being statistically significant(P<0.05).(7)The total effective rate was 96.23%(51/53)in observation group and 75.47%(40/53)in control group. The curative effect of the observation group was superior to the control group,the difference being statistically significant(P<0.05). Conclusion Acupuncture combined with massage in the treatment of VACS of blood stasis blocking collaterals syndrome can significantly inhibit inflammatory mediators, regulate vascular endothelial function,improve the patient’s vertebral artery blood supply and cervical function,and its clinical effect is significant.
作者
潘伟东
陈志标
罗卫平
钟原
杨小燕
徐帮杰
吴加利
张志强
聂钊源
PAN Wei-Dong;CHEN Zhi-Biao;LUO Wei-Ping;ZHONG Yuan;YANG Xiao-Yan;XU Bang-Jie;WU Jia-Li;ZHANG Zhi-Qiang;NIE Zhao-Yuan(Zhongshan Hospital of Traditional Chinese Medicine Affiliated to Guangzhou University of Chinese Medicine,Zhongshan 528401 Guangdong,China;The Third Hospital Affiliated to Guangzhou Medical University,Guangzhou 510150 Guangdong,China)
出处
《广州中医药大学学报》
CAS
2021年第9期1886-1893,共8页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
中山市医学科研资助项目(编号:2019A020462)。
关键词
针刺
推拿手法
瘀血阻络型
椎动脉型颈椎病
炎症介质
血管内皮功能
临床观察
acupuncture
massage manipulation
syndrome of blood stasis blocking collaterals
vertebral artery type cervical spondylosis
inflammation indicator
vascular endothelial function
clinical observation
